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Influence of family history and preventive health behaviors on colorectal cancer screening in African Americans

  1. Kathleen A. Griffith PhD, CRNP1,†,*,
  2. Deborah B. McGuire PhD, RN2,
  3. Renee Royak-Schaler PhD, Med3,
  4. Keith O. Plowden PhD, RN4,
  5. Eileen K. Steinberger MD, MS5

Article first published online: 9 JUN 2008

DOI: 10.1002/cncr.23550

Issue

Cancer

Cancer

Volume 113, Issue 2, pages 276–285, 15 July 2008

Additional Information

How to Cite

Griffith, K. A., McGuire, D. B., Royak-Schaler, R., Plowden, K. O. and Steinberger, E. K. (2008), Influence of family history and preventive health behaviors on colorectal cancer screening in African Americans. Cancer, 113: 276–285. doi: 10.1002/cncr.23550

Author Information

  1. 1

    The Johns Hopkins University School of Nursing, Baltimore, Maryland

  2. 2

    Department of Organizational Systems and Adult Health, University of Maryland at Baltimore, School of Nursing, Baltimore, Maryland

  3. 3

    Department of Epidemiology and Preventive Medicine, University of Maryland at Baltimore, School of Nursing, Baltimore, Maryland

  4. 4

    Department of Family and Community Health, University of Maryland at Baltimore, School of Nursing, Baltimore, Maryland

  5. 5

    Department of Epidemiology and Preventive Medicine, University of Maryland, Baltimore, School of Medicine, Baltimore, Maryland

  1. †

    Fax: (410) 614-1446

*Johns Hopkins University School ofNursing, 525 North Wolfe Street, Suite 306, Baltimore, MD 21205

Publication History

  1. Issue published online: 8 JUL 2008
  2. Article first published online: 9 JUN 2008
  3. Manuscript Accepted: 14 MAR 2008
  4. Manuscript Revised: 22 FEB 2008
  5. Manuscript Received: 27 NOV 2007

Funded by

  • The Maryland Cancer Survey
  • Maryland Cigarette Restitution Fund

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Keywords:

  • mass screening;
  • African Americans;
  • colorectal neoplasms;
  • disparity

The results from this study indicated that recommendations for colorectal cancer (CRC) screening tests and preventive health behaviors were predictive of risk-appropriate screening regardless of whether there was a family history of CRC among African Americans. Individuals who had a family history of CRC were less likely to complete screening than their average-risk counterparts.

Abstract

BACKGROUND.

African Americans (AAs) have low rates of colorectal cancer (CRC) screening. To the authors' knowledge, factors that influence their participation, especially individuals with a family history of CRC (“family history”), are not well understood.

METHODS.

A secondary analysis of the 2002 Maryland Cancer Survey data examined predictors of risk-appropriate, timely CRC screening (“screening”) in AAs with a family history and in individuals without a family history. Predictors that were evaluated included age, sex, family history, mammogram or prostate-specific antigen (PSA) screening, body mass index, activity, fruit/vegetable consumption, alcohol, smoking, perceived risk of cancer, education, employment, insurance, access to a healthcare provider, and healthcare provider recommendation of fecal occult blood test (FOBT) and/or sigmoidoscopy/colonoscopy.

RESULTS.

In individuals without a family history of CRC (N = 492), recommendation for FOBT (odds ratio [OR] of 11.90; 95% confidence interval [95% CI], 6.84–20.71) and sigmoidoscopy/colonscopy (OR of 7.06; 95% CI, 4.11–12.14), moderate/vigorous activity (OR of 1.74; 95% CI, 1.06–2.28), and PSA screening history (OR of 2.68; 95% CI, 1.01–7.81) were found to be predictive of screening. In individuals with a family history (N = 88), recommendation for sigmoidoscopy/colonscopy (OR of 24.3; 95%, CI 5.30–111.34) and vigorous activity (OR of 5.21; 95% CI, 1.09–24.88) were found to be predictive of screening. However, family history did not predict screening when the analysis was controlled for age, education, and insurance. AAs who had a family history were less likely to screen compared with their white counterparts (N = 293) and compared with AAs who were at average risk for CRC (P < .05).

CONCLUSIONS.

Regardless of family history, healthcare provider recommendation and activity level were important predictors of screening. Lower screening rates were observed in AAs who had a family history compared with individuals who did not. The authors believe that, for AAs who have a family history, further examination of barriers and facilitators to CRC screening within the cultural context is warranted. Cancer 2008. © 2008 American Cancer Society.

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